A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient
Background: Chylothorax is an abnormal accumulation of lymphatic fluid in the pleural cavity, and it develops because of chyle leaking from the thoracic duct. The clinical presentation can be varied, while symptoms depend on its size and the rate of accumulation in the pleural space. Diagnosis is ba...
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SMC MEDIA SRL
2025-02-01
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| Series: | European Journal of Case Reports in Internal Medicine |
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| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/4929 |
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| author | Umberto Giuseppe Galasso Elena Del Giudice Pasquale Ialongo Filippo Luca Fimognari Giovambattista Desideri Evaristo Ettorre Lorenzo Palleschi |
| author_facet | Umberto Giuseppe Galasso Elena Del Giudice Pasquale Ialongo Filippo Luca Fimognari Giovambattista Desideri Evaristo Ettorre Lorenzo Palleschi |
| author_sort | Umberto Giuseppe Galasso |
| collection | DOAJ |
| description | Background: Chylothorax is an abnormal accumulation of lymphatic fluid in the pleural cavity, and it develops because of chyle leaking from the thoracic duct. The clinical presentation can be varied, while symptoms depend on its size and the rate of accumulation in the pleural space. Diagnosis is based on pleural fluid analysis, supported by various imaging studies to help determine the underlying pathology and locate the site of chyle leak.
Case report: We report an extremely rare case of non-iatrogenic right-sided chylothorax in the absence of radiographically demonstrated bony damage which was related to vertebral osteophytosis in a 90-year-old man, who presented with worsening shortness of breath after a blunt trauma. On physical examination, the patient was found to be suffering from substantial right-sided pleural effusion with no radiographic evidence of traumatic injury.
Conclusion: Imaging demonstrated diffused osteophytosis at the level of the lower thoracic vertebrae, which were puncturing the thoracic duct. We adopted conservative treatment, including thoracentesis and total parenteral nutrition, which resulted in the improvement and resolution of symptoms. |
| format | Article |
| id | doaj-art-726558e93b934b2e8df0969e4df41d37 |
| institution | OA Journals |
| issn | 2284-2594 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj-art-726558e93b934b2e8df0969e4df41d372025-08-20T02:01:50ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942025-02-0110.12890/2025_0049294464A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patientUmberto Giuseppe Galasso0Elena Del Giudice1Pasquale Ialongo2Filippo Luca Fimognari3Giovambattista Desideri4Evaristo Ettorre5Lorenzo Palleschi6Department of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Geriatric Unit, Sapienza University of Rome, Rome, ItalyDepartment of Internal Medicine, Geriatric Unit, San Giovanni-Addolorata Hospital, Rome, ItalyDepartment of Radiology and Imaging, San Giovanni-Addolorata Hospital, Rome, ItalyDepartment of Internal Medicine, Geriatric Unit, Annunziata Hospital, Cosenza, ItalyDepartment of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Geriatric Unit, Sapienza University of Rome, Rome, ItalyDepartment of Clinical, Internal Medicine, Anesthesiologic and Cardiovascular Sciences, Geriatric Unit, Sapienza University of Rome, Rome, ItalyDepartment of Internal Medicine, Geriatric Unit, San Giovanni-Addolorata Hospital, Rome, ItalyBackground: Chylothorax is an abnormal accumulation of lymphatic fluid in the pleural cavity, and it develops because of chyle leaking from the thoracic duct. The clinical presentation can be varied, while symptoms depend on its size and the rate of accumulation in the pleural space. Diagnosis is based on pleural fluid analysis, supported by various imaging studies to help determine the underlying pathology and locate the site of chyle leak. Case report: We report an extremely rare case of non-iatrogenic right-sided chylothorax in the absence of radiographically demonstrated bony damage which was related to vertebral osteophytosis in a 90-year-old man, who presented with worsening shortness of breath after a blunt trauma. On physical examination, the patient was found to be suffering from substantial right-sided pleural effusion with no radiographic evidence of traumatic injury. Conclusion: Imaging demonstrated diffused osteophytosis at the level of the lower thoracic vertebrae, which were puncturing the thoracic duct. We adopted conservative treatment, including thoracentesis and total parenteral nutrition, which resulted in the improvement and resolution of symptoms.https://www.ejcrim.com/index.php/EJCRIM/article/view/4929chylothoraxvertebral osteophytosiselderly |
| spellingShingle | Umberto Giuseppe Galasso Elena Del Giudice Pasquale Ialongo Filippo Luca Fimognari Giovambattista Desideri Evaristo Ettorre Lorenzo Palleschi A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient European Journal of Case Reports in Internal Medicine chylothorax vertebral osteophytosis elderly |
| title | A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient |
| title_full | A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient |
| title_fullStr | A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient |
| title_full_unstemmed | A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient |
| title_short | A rare case of right-sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient |
| title_sort | rare case of right sided chylothorax induced by vertebral osteophytosis in a nonagenarian patient |
| topic | chylothorax vertebral osteophytosis elderly |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/4929 |
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